Visual hallucinations
Now when the nights are longer and there is less bright sunlight, visual hallucinations occur more often in the elderly, especially around sunset. We see this mainly when the patient has poor eyesight, especially with macular degeneration. However, the patient knows that what he or she sees is not real.
This is called Charles Bonnet Syndrome.
Last week I saw a patient with dementia. The man saw seven people in his room, right in front of him. It was a bit crowded, in his opinion. When I asked them where they were, he was pointing at them and counting (actually just reached the 5). In this case, he really thought they were there. Fortunately, he wasn’t afraid. That is actually the main thing you should check. There is no treatment, and the only thing you can do is to make sure there is a bright light. Very often, I see just a small lamp and curtains all closed. Another important thing to realize about someone with dementia. Their truth is the truth. You will never win a discussion, and you shouldn’t try it. It will frustrate both of you. So when there are seven people in the room, just check if your loved one is not afraid, and then try to change the subject or say something like: “they will probably leave later”.Note that hallucinations can also be caused by delirium. When you are unsure, or when there is a lot of fear you cannot deflect or decrease, ask a medical doctor to search for an underlying cause.
Checklist
- is there fear?
- turn on a bright light
- put on glasses when applicable
- don’t try to correct your loved one
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